Bromocriptine Mesylate

Trade Names

Cycloset
- Tablets 0.8 mg

Parlodel
- Capsules 5 mg

Parlodel SnapTabs
- Tablets 2.5 mg

Apo-Bromocriptine (Canada)PMS-Bromocriptine (Canada)

Pharmacology

Stimulates dopamine receptors in the corpus striatum, relieving parkinsonian symptoms. Inhibits prolactin, which is responsible for lactation, and lowers elevated blood levels of growth hormone in acromegaly. The mechanism in glycemic control is unknown.

Dopamine antagonists may reduce bromocriptine efficacy; bromocriptine may reduce effectiveness of dopamine antagonists. Concurrent use is not recommended.

Ergot drugs (eg, ergotamine)

Coadministration may increase occurrence of ergot-related side effects (eg, fatigue, nausea, vomiting) and may reduce effectiveness of ergot drugs when used to treat migraines. Concomitant use is not recommended.

Miscellaneous

Precautions

Monitor

Assess for exacerbation of Raynaud syndrome (eg, muscle cramps in hands or feet, cold feet). Periodic evaluation of hepatic, hematopoietic, CV, and renal function is recommended. Monitor patients throughout pregnancy for signs and symptoms of a prolactin-secreting tumor. Monitor BP, particularly during the first weeks of therapy.

Pregnancy

Category B .

Lactation

Contraindicated in breast-feeding women.

Children

Safety and efficacy in children 8 yr of age and younger not established for hyperprolactinemia. Safety and efficacy in children not established for all other indications.

Elderly

No overall differences in safety or effectiveness were observed, but greater sensitivity of some older patients cannot be ruled out.

Renal Function

Use with caution.

Hepatic Function

Use with caution.

Hazardous Tasks

Exercise care when driving a vehicle or operating machinery because hypotensive reactions may occur, especially during the first days of treatment.

CV effects

Symptomatic hypotension may occur. Hypertension, seizures, stroke, and MI have been reported in postpartum women on bromocriptine therapy. Use caution in patients with preeclampsia and in those who have received other drugs that may alter BP.

Cerebrospinal fluid rhinorrhea

May occur in patients with prolactin-secreting adenomas.

CNS effects

May be associated with confusion, mental disturbances, or hallucinations.

Galactose intolerance

Avoid use in patients with hereditary problems of galactose intolerance, severe lactase deficiency, or glucose-galactose malabsorption.

GI effects

Monitor for signs of GI bleeding.

MI

Exercise caution in patients with a history of MI who have a residual atrial, nodal, or ventricular arrhythmia.

Ophthalmic effects

Visual field impairment may occur. Monitor visual fields in patients with macroprolactinemia.

Parkinson disease

Safe use longer than 2 yr has not been established. Periodic evaluation of hepatic, hematopoietic, cardiac, and renal function is necessary.

Pituitary tumors

Evaluate pituitary before treatment to determine if tumor is present.

Psychotic disorders

May be exacerbated. Use in severe psychotic disorders is not recommended.

Pulmonary effects

Pleural and pericardial effusion, as well as pleural and pulmonary fibrosis and constrictive pericarditis, have been reported.

Retroperitoneal fibrosis

May occur. Monitor for signs of back pain, edema of lower limbs, or impaired kidney function.